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NPI Code Detail

MEDICARE: MS. ANGELA M DIXON MS, CCC-SLP

MEDICARE:  MS. ANGELA M DIXON  MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP1474AZ

General Provider Information

NPI Number : 1194998088
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA M DIXON MS, CCC-SLP
Provider Business Mailing Address
First Line : 16410 S 12TH STREET
Second Line : #233
City : PHOENIX
State : AZ
Zip : 85048
Country : US
Telephone Number : 602-510-8355
Fax Number :
Provider Business Practice Location Address
First Line : 16410 S 12TH ST APT 233
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-4008
Country : US
Telephone Number : 602-510-8355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2008
Last Update Date : 01/05/2021

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Directions to “ MS. ANGELA M DIXON MS, CCC-SLP” Practice Location

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